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General NPI Number Information
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NPI Number | 1710299706
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Entity Type | Individual
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Provider Name | ALONSO CARRASCO JR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2010
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 2530 CHICAGO AVE STE 550
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-4293
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Country | US
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Telephone | 612-813-8000
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Fax | 612-813-8005
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Provider Business Mailing Address
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Address Line | 4530 77TH ST W STE 205
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City | EDINA
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State | MN
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Zip | 55435-5003
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Country | US
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Telephone | 612-813-8000
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Fax | 952-835-9443
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number | 04-39904
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number | 54064
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number | 2017002201
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number | V8469
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number | DR.0055046
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License Number State | CO
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